Aragón Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
Biomech Model Mechanobiol. 2021 Apr;20(2):767-786. doi: 10.1007/s10237-020-01415-3. Epub 2021 Feb 3.
In the last decade, many computational models have been developed to describe the transport of drug eluted from stents and the subsequent uptake into arterial tissue. Each of these models has its own set of limitations: for example, models typically employ simplified stent and arterial geometries, some models assume a homogeneous arterial wall, and others neglect the influence of blood flow and plasma filtration on the drug transport process. In this study, we focus on two common limitations. Specifically, we provide a comprehensive investigation of the influence of arterial curvature and plaque composition on drug transport in the arterial wall following drug-eluting stent implantation. The arterial wall is considered as a three-layered structure including the subendothelial space, the media and the adventitia, with porous membranes separating them (endothelium, internal and external elastic lamina). Blood flow is modelled by the Navier-Stokes equations, while Darcy's law is used to calculate plasma filtration through the porous layers. Our findings demonstrate that arterial curvature and plaque composition have important influences on the spatiotemporal distribution of drug, with potential implications in terms of effectiveness of the treatment. Since the majority of computational models tend to neglect these features, these models are likely to be under- or over-estimating drug uptake and redistribution in arterial tissue.
在过去的十年中,已经开发出许多计算模型来描述从支架洗脱的药物的输送以及随后进入动脉组织的情况。这些模型中的每一个都有其自身的局限性:例如,模型通常采用简化的支架和动脉几何形状,一些模型假设动脉壁是均匀的,而其他模型则忽略了血流和血浆过滤对药物输送过程的影响。在本研究中,我们重点关注两个常见的局限性。具体来说,我们全面研究了动脉弯曲度和斑块组成对药物洗脱支架植入后动脉壁内药物输送的影响。将动脉壁视为包括内膜下腔、中膜和外膜在内的三层结构,多孔膜将它们分隔开(内皮、内弹性膜和外弹性膜)。血流通过纳维-斯托克斯方程建模,而通过多孔层的血浆过滤则使用达西定律计算。我们的研究结果表明,动脉弯曲度和斑块组成对药物的时空分布有重要影响,这可能对治疗效果产生影响。由于大多数计算模型往往忽略这些特征,因此这些模型可能低估或高估了药物在动脉组织中的摄取和再分布。